Refugee camps, not surprisingly, are rather unhealthy places to be. For one thing, there are the effects of the natural disaster that usually drive refugees to a temporary settlement. There’s also the threat of hunger and thirst — as we now see among Somali refugees who fleeing a devastating famine in their home country.

But there’s something about the nature of a refugee settlement itself that promotes the spread of disease: thousands — if not far more — stressed people may be crowded into cramped conditions, often without proper sanitation or medical care; that’s a perfect breeding ground for epidemics of cholera, malaria, dengue fever, tuberculosis and other deadly diseases. In fact, in the wake of a major natural catastrophe, it’s often disease among refugees that poses the single greatest threat to health.

The Occupy camps that have sprung up in major cities around the U.S. may not be equivalent to makeshift refugee settlements in East Africa — there are a lot more drum circles at Occupy, for one thing — but they could similarly become loci for the spread of disease, especially as the weather turns colder. That concern has already arisen at the Occupy Wall Street camp in Zuccotti Park, as Matt Flegenheimer of the New York Timesreported:

The city’s health department said that officials had visited the park and that it would continue to monitor conditions with winter looming. “It should go without saying that lots of people sleeping outside in a park as we head toward winter is not an ideal situation for anyone’s health,” the department said in a statement.

Dr. Philip M. Tierno Jr., the director of clinical microbiology and immunology at NYU Langone Medical Center, said the conditions could leave park-dwellers susceptible to respiratory viruses; norovirus, the so-called winter vomiting virus, which can lead to vomiting and diarrhea and which could quickly overwhelm the limited bathroom facilities in the area; and tuberculosis, which is more common in indigent populations and can be spread by coughing.

There’s a certain duh element here — when it gets cold and rainy, people get sick, and when there are lots of sick people sharing living and sleeping space, they spread their disease. That might just be the price of direct democracy, though it would help if city officials allowed better heating equipment and other more permanent shelters that might stave off the spread of disease.

A bigger concern than a few cases of the sniffles would be the spread of more dangerous bugs, like tuberculosis, which is a scourge of actual refugee camps. And that may be happening at Occupy Atlanta. On Nov. 8 the Atlanta Journal-Constitutionreported that county health officials had found people recently diagnosed with drug-resistant, active TB in the homeless shelter that Occupy is using as its base.

For now the group itself says that members were tested for TB and no one came back positive, which is good news. But as the weather gets worse and the occupation stretches on, things could get a little medieval down there.